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1104471135
DAVID ALLEN LOGUE
SANTA ROSA, CA
NPI
1104471135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-08-06
Last Update Date
2019-08-06
Business Address
DAVID ALLEN LOGUE
440 ARROWOOD DR
SANTA ROSA, CA 95407-7503
Phone number: 707-284-2950
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Mailing Address
DAVID ALLEN LOGUE
440 ARROWOOD DR
SANTA ROSA, CA 95407-7503
Phone number: 707-284-2950
Copy
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